Nurse Residency Program in Ambulatory Care

Abstract
Purpose: The purpose of the project was to determine the feasibility of developing and implementing an Ambulatory Nurse Residency Program (ANRP) in an academic medical center. Nurse residency programs (NRPs) are designed to ease the transition from nursing student to professional nurse. The traditional NRPs have been focused on new graduates for the inpatient units; however, a changing healthcare environment requires incorporating preparation for the ambulatory care setting.
Research Question: Is it feasible to develop and implement an Ambulatory Nurse Residency Program (ANRP) in an academic medical center?
Setting and Sample: This was a single-site study conducted in the ambulatory clinics of a 600 bed academic medical center located in central Virginia. In 2016, three new graduates were given the opportunity to participate in an ANRP and were invited to participate in this study along with their ambulatory care preceptors and the nurse managers who hired them.
Methods: This study used a three-pronged qualitative descriptive design to assess the feasibility of developing and implementing an ANRP: 1) An investigator developed Preceptor/ Manager Evaluation Survey was used to collect the perceptions of preceptors and managers about the strengths and limitations of the ANRP; 2) Structured interviews were used to collect qualitative information from the three initial program participants; and, 3) Two ambulatory care experts reviewed and critiqued the Ambulatory Nurse Residency Program Manual.
Results: All mean scores of the Preceptor/ Manager Evaluation Survey were above the midpoint of 2.5, which indicated a favorable response about the participant’s readiness to practice. Managers however, ranked the participants’ readiness to practice lower than the preceptors. Peer and manager support were found to be important during the new graduates’ transition from new graduate to competent nurse. However, participants expressed a need for increased leadership support during clinical rotations. Mean scores of the manual evaluation were also above the midpoint of 2.5, indicating a favorable response to the manual.
Nursing Implications: This study informed the development of a NRP in the ambulatory setting, which provided a solution for growing nursing shortages in ambulatory care.